The physical wounds suffered by those injured in Sunday morning's deadly Metro-North derailment in the Bronx were still being addressed Monday.
But Dr. David Listman, the emergency room director at St. Barnabas Hospital, said the victims also face the prospect of mental anguish and trauma.
"People are still in the acute state of coming to grips with the injuries and the accident," Listman said. "I think for a lot of people, as they go home and life goes back to normal, it's going to be difficult to deal with this."
Listman said that, for a large number of the dozens injured in the crash, taking Metro-North is "something that's part of their regular day" -- and that just getting on a train again is going to be "very difficult for people."
Most of the cars in the seven-car train derailed at 7:20 a.m. Sunday on a sharp turn just north of the Spuyten Duyvil station in the Bronx. Four passengers died and 11 were critically injured, according to the FDNY.
The injured were taken to St. Barnabas, Montefiore Medical Center, Lincoln Medical and Mental Health Center, and Jacobi Medical Center in the Bronx; NewYork-Presbyterian Hospital/Allen Pavillion in Manhattan; and Elmhurst Hospital Center in Queens, authorities said.
Twelve of the patients went to St. Barnabas, Listman said. Eight of those patients remained there Monday night, a spokesman said, and one had been discharged.
One of the original 12 patients taken to St. Barnabas was transferred to another hospital on Sunday.
Seven of the eight who remained overnight were kept in the intensive care unit, Listman said. Two had "significant" spinal injuries, he said -- one, whom hospital officials described as a 43-year-old man, underwent surgery in an attempt to relieve pressure to his spinal cord, he said.
Most of the injuries, he said, involved musculoskeletal injuries, as well as some minor head injuries. Some suffered fractures, including some collarbone fractures.
"The patients, overall, are doing well," Listman said, adding that many were being comforted by family members.
"There were very significant traumatic injuries," he said. "I think we were fortunate that we didn't see more severe head injuries or inter-abdominal injuries that required immediate surgery."
Listman said staff had already begun to address "emotional and psychological" injuries as a follow-up treatment for patients.
Other hospitals were reporting similar status updates.
A spokesman for Jacobi Medical Center said Monday that 11 of the 13 patients taken there on Sunday had been treated and released. Officials at NewYork-Presbyterian Hospital said four of the injured taken to The Allen Hospital on Sunday had been treated and released.
Fourteen others were taken to NewYork-Presbyterian/Columbia University Medical Center, with eight treated and released by Monday. Officials said six remained at the hospital, and that two of them were in critical condition at the hospital on Monday.
FDNY Chief of Department Edward Kilduff said that three of the four people who died in the wreck were found outside the train. All of the fatalities involved train cars that flipped onto their sides.
Officials estimated there were about 100 or so passengers aboard the train -- much fewer than would have been aboard the train on a weekday.
FDNY Commissioner Salvatore J. Cassano said that, had the train been fully occupied, the accident would have been an even bigger disaster.
Visiting Montefiore Medical Center on Sunday, Mayor Michael Bloomberg said it appeared most of the critically injured there were not in life-threatening condition.
He said he chatted and joked with a few of those injured.
"The two families that I talked to, their loved ones were in serious, but not critical condition, and the doctors had told them both they were going to survive, with some pain and that sort of thing," he said.
Bloomberg, who had visited St. Barnabas Hospital earlier in the day, said the two seriously injured patients he saw at Montefiore were "very badly banged up" and in one case the victim was in the operating room so he spoke with family members.
With John Valenti
and Ivan Pereira